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DISCLOSURE STATBHBHT FOR OWNER. CITY OF ZEPHYlmILLS BUILDING DEPARTMENT C\ ,.., I, (_ \ \ ,:'1'\(, V.... (\\; (-,I... ,," " have read and ful~y understand and agree to the provisions of this instrument. The undersigned states and affirms that he or she. is desirous of constructing, renovating, adding to or reroofing his or her own domici~e" that he or she actua~ly occupies, or will occupy by said domici~e, and same is not for rent, lease or sale. That he or she shal~ comply with the fol~owing conditions,: 1. That the owner and he or she a~one sha~~ act as the bui~derfor a~~ phases of.. construction. 2. That the owner wi~~ comp~y with a~~ provisions of the City of Zephyrhi~~s ordinances and codes pertinent to "the bui~ding. 3. That in the event various phases of construction are subcontracted, he wi~l engage on~y properly licensed subcontractors and wil~ personally supervise such work., 4. That in the event the Building ::Inspector shaJ.l require corrections to be made, the owner will assume full responsibility to insure the.y are made, and upon completion wili call for a reinspection before proceeding with the 'building. 5. That the oWner shall assume full responsibi'~ity for the construction and will not expect supervision of his work from the City of Zephyrhills Building Department. 6. That prior to final inspection any additional fees, including reinspection fees, must be paid in full. A written request from this office shall ,constitute' an officia~ notice, to pay additional fees. 7. That the owner shall comply with all City, State and Federal laws'in regard to social security~ workman's compensation, lien laws, etc., where applicable. 8. That the owner shall comply with all the safety codes issued by the P'lorida Industria~ Commission. ' 9. State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor with certain, restrictions even though you do not have a license. You must provide direct onsite supervision of the construction yourself. You may build or impr'?Vea one-fami~y or two-family residence or a farm outbuilding. You may also build or improve a commercial building, provided your costs do not exceed $25,000. The building or residence must be for your own use or occupancy. ::It may not be built or. s;Wstantia~~y improved for sale or lease. ::If you seJ.1.;or' lease a building you have built or substantially imp~oved YQurse~f within 1 year after the construction is complete, the law will presume 'that you built or substantia~~y improved if for sa~e or lease, which is a. violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building. ::It is your responsibi1i ty to make sure that people employed by you have ~icenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must 'deduct P'.::I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by iaw. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulat10ns. =~~ '~~~;"';}*~fL<~'2<' ) PBONE,',\' '> 1 ~'5 "\' '(",\ -y~. DATE ry-\( ~:~ ()- (j(C/ WJ:TNESS PERKrT #